Allen Sean T, Weir Brian W, Reid Molly, Schneider Kristin E, O'Rourke Allison, Hazelett Tim, Kilkenny Michael E, Latkin Carl
Department of Health, Behavior and Society , Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 184, Baltimore, MD, 21205, USA.
DC Center for AIDS Research, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, 20052, USA.
AIDS Behav. 2025 May;29(5):1449-1457. doi: 10.1007/s10461-025-04615-z. Epub 2025 Jan 20.
This study aimed to examine shifts in the cost-savings threshold of a rural syringe services program (SSP) that resulted in the 12-months following the identification of the COVID-19 pandemic. We compared SSP operational costs during the 12-months immediately before and after identification of the COVID-19 pandemic using administrative data from the Cabell-Huntington Harm Reduction Program (CHHRP), which is operated by the Cabell-Huntington Health Department in West Virginia. Data included monthly counts of client encounters, sterile syringe distribution, and HIV testing. Cost-savings threshold analyses were conducted to estimate the number of HIV infections that would have to be averted for the CHHRP to be cost-saving in the 12-months before and after the identification of the COVID-19 pandemic. In the 12-months following identification of the COVID-19 pandemic, there was a 13.6% reduction in the number of client encounters and a 69.3% reduction in the number of HIV tests administered at the CHHRP. From the healthcare perspective, in the 12-months before and after the pandemic, the CHHRP cost $190,151 and $116,727, respectively. The number of averted HIV infections required for the CHHRP to be cost-saving was less than one across both time periods and for all estimates of lifetime HIV-related medical costs. There were shifts in the operational costs at the CHHRP after the identification of the COVID-19 pandemic; however, the costs of providing harm reduction services were significantly less than lifetime HIV treatment costs for a single person. Increasing investments in harm reduction is essential for eliminating HIV transmission.
本研究旨在考察农村注射器服务项目（SSP）在确定新冠疫情后的12个月内成本节约阈值的变化情况。我们利用西弗吉尼亚州卡贝尔 - 亨廷顿卫生部门运营的卡贝尔 - 亨廷顿减少伤害项目（CHHRP）的行政数据，比较了在确定新冠疫情前后紧挨着的12个月内SSP的运营成本。数据包括每月的客户接触次数、无菌注射器分发量和HIV检测量。进行了成本节约阈值分析，以估计在确定新冠疫情前后的12个月内，CHHRP要实现成本节约必须避免的HIV感染数量。在确定新冠疫情后的12个月里，CHHRP的客户接触次数减少了13.6%，HIV检测量减少了69.3%。从医疗保健角度来看，在疫情前后的12个月里，CHHRP的成本分别为190,151美元和116,727美元。在两个时间段以及对所有终身HIV相关医疗成本的估计中，CHHRP要实现成本节约所需避免的HIV感染数量均少于一例。在确定新冠疫情后，CHHRP的运营成本发生了变化；然而，提供减少伤害服务的成本显著低于一个人终身的HIV治疗成本。增加对减少伤害的投资对于消除HIV传播至关重要。
